Fantastic Smiles LTD.

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

019-024294 Issued in IL

Legal business name

FANTASTIC SMILES LTD.

Practice address

250 W Kensington Rd
Suite 2a
Mt Prospect, IL 60056-1293

Phone

(847) 577-5464

Fax

(847) 577-5474

NPI assigned

Oct 18, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Ewa Koser, DDSNPI 1518010669

Title

President

Phone

(847) 577-5464

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ewa P Koser, DDS

  • General Practice Dentistry
  • Mount Prospect, IL
  • NPI 1518010669
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1382054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1382054400000",
    "number": "1104254630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 W KENSINGTON RD",
            "address_2": "SUITE 2A",
            "city": "MT PROSPECT",
            "state": "IL",
            "postal_code": "600561293",
            "telephone_number": "847-577-5464",
            "fax_number": "847-577-5474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 W KENSINGTON RD",
            "address_2": "SUITE 2A",
            "city": "MT PROSPECT",
            "state": "IL",
            "postal_code": "600561293",
            "telephone_number": "847-577-5464",
            "fax_number": "847-577-5474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FANTASTIC SMILES LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-18",
        "last_updated": "2013-10-18",
        "status": "A",
        "authorized_official_last_name": "KOSER",
        "authorized_official_first_name": "EWA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-577-5464",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "IL",
            "license": "019-024294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Euclid Advanced Dentistry, P.C
• Patricia Evangelou
• Excellence Safe Home Care LLC
• Family Medicine Specialists of Mount Prospect S C
• Family Wellness Clinic LTD
• Mary Farley, APRN
• Feyintolu M. Balogun, DPM PLLC
• William Bartley Finnerty, PHARM.D.
• First Smile HD 3D 4D Ultrasound LLC
• First Surgical Inc.

• Dental Clinic/Center in Mt Prospect, IL
• Providers in Mt Prospect, IL by specialty
• Dental Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.